UNFPA, Population Services International (PSI), UNICEF, and
Family Planning Service Expansion and Technical Support Project (SEATS), a US
NGO.

Objectives

The programme seeks to improve health for all young people 14 to
30 years of age by training volunteers in reproductive health and family
planning so that they can establish peer education programmes in their schools
and share their knowledge with their peer group.

Background

In 1993, following a 30-year struggle, Eritrea become the most
recent independent nation in Africa (Africa's 52nd nation). It faces many
serious problems. Nearly a quarter of Eritrean women marry before they are 15
years old and many bear children before their bodies are fully developed. Total
fertility for the whole country is 6.1 children per woman (3.7 for the city of
Asmara). The large number of births, spaced very closely, contributes to both
maternal and infant mortality. The contraceptive prevalence rate is only 26 per
cent in Asmara and 8 per cent for the country. As well, Eritrea suffers from an
illiteracy rate of over 80 per cent, an acute shortage of schoolteachers and
instructional materials and equipment, uneven distribution of educational
resources, and the absence of vocational training opportunities. About 5,787
cases of AIDS had been reported by the National AIDS Control Programme (NACP) of
Eritrea by late 1998, and it is believed that HIV prevalence is growing rapidly,
doubling every 18 months.

The youth of Eritrea (aged 14-24) account for approximately
30-35 per cent of the total population. There are insufficient school places and
jobs, leaving many young people untrained and with few ways to contribute
productively to their society. It is estimated that 20,000 young people are in
school and 700,000 are out of school.

In Eritrea, it has traditionally been difficult for young people
to get information on sexual and health matters. The family is often unprepared
to deal with the educational, informational, and social needs of its children,
and a traditional Eritrean family does not normally discuss sexual issues with
children. Nor has the school system traditionally provided sex-related
education. Similarly, there are few other institutions that cater to the
physical and psychological needs of the young. Consequently, the youth of
Eritrea tend to be ignorant on issues related to sexuality and
adolescent/reproductive health.

The National Union of Eritrean Youth and Students (NUEYS) is a
national non-governmental organization whose goal is to advance education and
improve employment opportunities for youth. It has evolved into a strong,
nationwide network, with a membership of over 138,000 young people, a paid staff
of 269 within 51 urban and rural offices and sub-offices, and an even larger
volunteer workforce, about half of which are women. NUEYS has a cooperative
relationship with both local and foreign NGOs, UN agencies, and government
ministries, and has participated in the implementation of a broad range of
activities and projects throughout Eritrea, including four health centres.

Main Activities

Given the prevailing situation and indications of an increase in
the problems of young people and their poor awareness about reproductive health
and responsible sexuality, NUEYS and the Planned Parenthood Association of
Eritrea (PPAE) in 1994 designed a project of comprehensive reproductive health
education and services. In recent years, HIV activities have taken on a larger
profile in the overall effort. They include.

- Regular sensitization seminars for high school
students: These basically cover topics of population dynamics, anatomy and
physiology of reproductive organs, what adolescence is, changes in adolescence,
how pregnancy occurs, methods to prevent pregnancy, and STDs with emphasis on
HIV/AIDS.

- Peer education programme: The trained youth are encouraged to
hold meetings with their peer groups in their schools, at NUEYS health centres,
and at NUEYS rural and urban offices.

- Workshop on how to involve men in family planning and
introducing female condoms: Part of the messages given to men here is that using
the female condoms would both facilitate family planning and prevent infecting
partners with STDs including HIV/AIDS.

- Condom distribution: Condoms are distributed through the
centres to STD clients and others. They are also distributed in the various
sites where health orientation seminars are given and health training is done.

- Provision of clinical STD case management and family planning
services, reproductive health counselling, library and recreational services for
young people: These are the services that the youth-friendly centres provide to
clients on a daily basis. In each of the services mentioned above there is an
HIV/AIDS component. In the library and recreation centres for instance, there
are I EC materials and other health booklets that speak specifically about
HIV/AIDS. Part of the recreation provided is video shows that include movies
that are HIV/AIDS-specific.

- Drama and film production: Several drama shows have been
organized and shown to youth and the public, some only in Asmara and others
throughout the country using a mobile drama group. These shows are always
accompanied by the distribution of condoms and different campaign materials.
NUEYS recently coproduced a film on HIV/AIDS and youth. Using language young
people understand, it deals with the current behaviours of and problems facing
Eritrean young people. This film was launched in the presence of many
collaborating NGO representatives, youth leaders, MOH officials, and others and
was broadcast on national TV on the World AIDS-Day Campaign launching day.

- Radio and newspaper: NUEYS is using one of its three
newspapers to publish HIV/AIDS and other reproductive health-related articles
addressing questions from youth on social issues like dating, friendship, love
and sex, school and peers, peer pressure, and so forth. The articles are
published every other week, with an overall goal of promoting healthy and safe
sexual behaviour in young people. As well, NUEYS, in agreement with the Ministry
of Information, has national radio airtime every Saturday from 2 to 3 P.M.,
during which youth issues are broadcast. Health messages are incorporated into
these radio programmes, presented in drama, poems, and other forms. NUEYS
organized a two-hour live radio programme for the 1999 World AIDS Day
activities.

Outcomes

A review of the cumulative achievements of the four health
centres shows strong growth of services from 1996 to 1999. It is difficult to
separate the HIV/AIDS component from other activities, but the following figures
have been collected. Note that the clients are people between the ages of 14 and
35, in Asmara and other towns in which the centres are found. They are served
regardless of their membership in the union and their sex, religion, ethnic
group, or other characteristics.

Year

1996

1997

1998

1999

Clinical and counselling services clients

86

577

1,219

1,700

Training activities trainees

145

158

87

154

Library and recreational services users

984

15,282

19,974

70,832

Sensitization activity/orientation seminar participants

3,210

25,730

25,570

33,400

However, NUEYS faces serious limitations in funding and other
resources, and has been offering all of its services for free. Although free
services may be appropriate given the general levels of poverty, the fact
remains that NUEYS must find new sources of funding if services are to be
enhanced, or even sustained.

Lessons Learned

The programme illustrates the potential of a national,
mass-based organization like NUEYS to participate in a major public health
effort - in this case, to mobilize young people against HIV/AIDS and reach out
to them with services. The national union's size allows it to participate as a
partner with government ministries and major international NGOs, possibilities
that would be denied an organization with fewer members or a smaller geographic
coverage.

An important lesson learned by NUEYS in all its activities is
that different populations of young people must be reached in different ways. It
is relatively straightforward to bring HIV/AIDS information and activities to
young people in school, but the difficult situation of the country means that
concentrating only on school-based activities would miss large numbers of
potential beneficiaries. Therefore, the strategy of diversity - attacking the
problem of HIV/AIDS and the lack of reproductive health knowledge from multiple
directions and using various media - is the most effective way to reach all
young people, including some of the most vulnerable such as those who are out of
school but living in or near urban
areas.